Radix EntomolarisCase 1A 48-year-old female patient without any presented with complaints of pain in the left lower molar region.She reported a history of periodic discomfort for the previous month, which has intensified over the last 3 days.Upon clinical examination, the left mandibular first molar exhibited extensive proximal caries and was sensitive to percussion.The thermal and electrical pulp tests of the tooth yielded a negative result.The preoperative radiograph revealed an expansion of the periodontal ligament space along with a diffuse periradicular radiolucency and an extra root situated between the mesial and distal roots (Fig. 1 ).Two radiographs with varying horizontal angulations were obtained, confirming that the supplementary root was situated introduCtionThe success of endodontic therapy relies on the accurate identification of all canals, comprehensive chemomechanical preparation, and subsequent three-dimensional obturation with a hermetic seal. 1 Expertise in dental anatomy and awareness of potential deviations from what is usual are essential for success in endodontics.Insufficient instrumentation and cleansing of the root canal space, together with inadequate obturation, are the primary causes of endodontic failure. 2 Mandibular molars typically consist of the mesial root contains two root canals, each terminating in a separate apical foramina.Occasionally, these converge at the root apex to culminate in a single foramen.The distal root often has a single kidney-shaped root canal; however, if the opening is notably narrow and circular, a second distal canal may exist. 3The number of roots may also fluctuate, similar to the number of root canals.A supplementary third root, initially referenced in literature by Carabelli, 4 is termed the radix entomolaris (RE).The supernumerary root is situated distolingually in mandibular molars, primarily in the first molars.A supplementary root located on the mesiobuccal aspect is referred to as the radix paramolaris (RP). 5Additionally, the incidence of RP is significantly lower compared to that of RE. 6 The existence of an extra root in mandibular molars has clinical ramifications for endodontic therapy.The recognition of this supplementary root prevents the oversight of a canal, which may result in problems and treatment failure. 7Walker and Quackenbush 8 reported a 90% precision in diagnosing three-rooted molars using only panoramic radiographs.Although superimpositions on the preoperative radiographic image, which may result in inaccuracies in identifying this anatomical variation.Taking additional exposures by altering the horizontal angulation of the primary X-ray beam is beneficial. 9This report presents four such cases.Two reports comprise RE, while two others consist of RP.The clinical methodology of diagnosis as well as endodontic treatment is examined and illustrated.
Satpute et al. (Wed,) studied this question.